| NPI | 1326156936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: OR RPH-0010684) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: WA PH00060941) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-07-08 |